Healthcare Provider Details

I. General information

NPI: 1467066498
Provider Name (Legal Business Name): DANA LYNN GREENE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 NE DIXIE HWY STE A6
STUART FL
34994-1882
US

IV. Provider business mailing address

50 NE DIXIE HWY STE A6
STUART FL
34994-1882
US

V. Phone/Fax

Practice location:
  • Phone: 772-302-3568
  • Fax: 772-588-1116
Mailing address:
  • Phone: 722-259-1725
  • Fax: 772-588-1116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11009354
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: